Active NPI
Jessica Shante Green, LMSW
- Social Worker
- Bel Air, MD
National Provider Identifier
1518641471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 30282
- Practice address
- 1208 E Churchville Rd Ste 300
Bel Air, MD 21014-3485 - Phone
- (410) 893-4600
- NPI assigned
- Jun 12, 2023
- Last updated
- Jun 30, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | MSW010482 | GA | |
| Social Worker | 104100000X | 0903003712 | VA | |
| Social Worker | 104100000X | 30282 | MD | Primary |
Addresses
Primary practice location
1208 E Churchville Rd Ste 300
Bel Air, MD 21014-3485
Mailing address
950 S George Mason Dr Apt 714
Arlington, VA 22204-1864
Phone (706) 329-7050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MSW010482 | GA | MD | Social Worker |
| 0903003712 | VA | MD | Social Worker |
| 30282 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688083200000",
"number": "1518641471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 S GEORGE MASON DR APT 714",
"city": "ARLINGTON",
"state": "VA",
"postal_code": "222041864",
"telephone_number": "706-329-7050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1208 E CHURCHVILLE RD STE 300",
"city": "BEL AIR",
"state": "MD",
"postal_code": "210143485",
"telephone_number": "410-893-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "JESSICA",
"middle_name": "SHANTE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-12",
"last_updated": "2023-06-30",
"certification_date": "2023-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "GA",
"license": "MSW010482",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "VA",
"license": "0903003712",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "30282",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bel Air, MD
- Greater New Jersey Neuromonitoring LLC
- Ellen Greaver
- Horace Andrew Greeley
- Carolyn McComas Greely, DNP
- Green Door Family Psychiatry LLC
- Nicole E Green, PA-C
- Elizabeth Jane Greeno, PHD, LCSW-C
- Carine Gregory, MD
- Grey Matter Counseling & Consulting, LLC (Grey Matter Counseling & Consulting)
- Amy Griffin, SLP-CCC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.